| Doctor Name: | MRS. KATISHA SCHNAE NIELSEN |
| NPI Number: | 1073786067 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.D |
| License Number: | |
| Business Practice Address: | 10 W Pinehurst Cir Apt 202 Glendale Heights, IL - 601393629 |
| Business Phone Number: | 6305502331 |
| Business Fax Number: | 6305178942 |
| Mailing Address: | 10 W Pinehurst Cir Apt 202, GLENDALE HEIGHTS |
| State: | IL |
| Postal Code: | 601393629 |
| Phone Number: | 6305502331 |
| Fax Number: | 6305178942 |
| NPI Enumeration Date: | 04/10/2008 |
| NPI Last Update Date: | 04/10/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133NN1002X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Nutritionist |
| Taxonomy Specialization: | Nutrition, Education |
| Taxonomy Definition: | |